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Cerebral Perfusion during Aortic Arch Surgery

Albers, E.C. (2022) Cerebral Perfusion during Aortic Arch Surgery.

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Abstract:Aortic arch surgery has a high risk of post-operative neurological deficits. A mismatch between cerebral oxygen supply and demand is considered to be an important factor for these neurological deficits. In order to evaluate the impact of the multiple pathophysiological processes influencing cerebral blood flow and metabolism simultaneously, a multimodal approach is necessary. The aim of the study was to test feasibility of a multimodal set-up, and to measure cerebral supply and demand during and after aortic arch surgery. In this study cerebral supply and demand parameters will be monitored with Near-infrared Spectroscopy, Electroencephalography, Transcranial Doppler and jugular venous oximetry. The secondary outcome in this thesis is the cerebral supply and demand parameters, and their interaction, over time from the start of surgery until the moment of awakening at the ICU. Four patients were included in this study. Mean arterial pressure and mean flow velocity in the middle cerebral artery increased from surgery to ICU while relative power in the delta band decreased. The results showed a high interpatient variability. In this study we have shown feasibility of multimodal neuromonitoring during aortic arch surgery. The method described in this study facilitates simultaneous analysis of multiple cerebral hemodynamic regulatory mechanisms.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine, 50 technical science in general
Programme:Technical Medicine MSc (60033)
Link to this item:https://purl.utwente.nl/essays/93795
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